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Municipal Facility and Street Naming Application and Requirements

 

Information Required

  • Reason/Justification for Request
  • Biography of the person, if available
  • Family Consent, if available
  • Site location (provide address or map showing the site)
  • Articles/newspaper clippings, if applicable
  • Awards/citations, if applicable
  • Description of theme, if applicable

 

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Please be advised that the applicant will pay for the costs incurred by the City of Medicine Hat to rename a park, road, or a municipal facility.

By submitting this application/form you acknowledge and agree that any electronic signature provided by you herein is the same as a handwritten signature for the purposes of legality, validity, enforceability, and admissibility.

Clear

Pursuant to s. 33 (c) of the Freedom of Information and the Protection of Privacy Act, the personal information collected on this form is for the purpose of an operating program or activity of the City of Medicine Hat. The City of Medicine Hat must collect personal information directly from the individual that the information is about unless another method of collection is authorized by the individual or by an enactment of Alberta or Canada. The personal information provided will be protected under Part 2 of the Freedom of Information and the Protection of Privacy Act and will be used for processing your application.

Questions regarding the collection and use of personal information can be directed to the FOIPP Head of Local Body at 403 529 8234